Safety net: Police training diverts mentally ill from jails

Called to a group home to assist with a resident diagnosed with schizophrenia, Gibsonville Police Chief Mike Woznick is quick to say the outcome would have been very different just a few years ago.

The caregiver there was so frustrated March 20 that they called police to remove the man from the home.

“In the past, we probably would have just taken him to jail,” Woznick said Friday. “That would have been a very likely result of him dealing with law enforcement.”

Instead, the officer who arrived diffused the situation. The man — whom Woznick described as “calm and lucid” — was taken to his family in Greensboro. In conversation with the officer and family members, he agreed to an appointment with his mental health provider for a check-up.

That outcome was the result of Crisis Intervention Team training, a program aimed at educating law enforcement about the symptoms of mental illness and diverting the mentally ill from unnecessary incarceration into treatment.

The shrinking of the state’s mental health system — resulting in a lack of beds at psychiatric hospitals and less access to care locally — means that many people suffering from mental illnesses aren’t receiving correct treatment. Left untreated, their conditions can worsen to the point their behavior becomes abnormal, sometimes even threatening.

That’s when police are called.

“The way things have played out is that our safety net largely consists of law enforcement and (hospital) emergency departments,” said Mike Mayer, a member of the state board for the National Alliance on Mental Illness. “Law enforcement knows they have very few options for dealing with folks with mental illness. Jail is containment, not treatment … and the emergency room is a terrible place to try to get mental health treatment.”

Lack of mental health resources and education has led to jails and prisons serving as stand-in mental hospitals.

Nationwide, there were more than three times more seriously mentally ill people in jails and prisons than in hospitals, according to data collected in 2004 and 2005 by the Treatment Advocacy Center. An estimated 300,000 mentally ill were incarcerated, compared to 71,000 available beds at mental health treatment centers.

Studies by NAMI show that as many as 40 percent of people with a diagnosed mental illness pass through the criminal justice system at some point — and as many as half of those will end up back in custody. In 2004, more than half of all inmates with mental illnesses reported having three or more prior convictions. Incarceration of the mentally ill costs about $9 billion each year.

Treatment, rather than incarceration, prevents both non-violent and violent offenses by those with mental disorders, NAMI says.

While CIT training doesn’t add to the state’s mental health resources, it works to direct people with mental illness into treatment rather than a cycle of imprisonment.

THE CIT PROGRAM was developed in Memphis, Tenn., in 1988. North Carolina’s first CIT program came to Wake County in 2005.

Gerry Ackland, of NAMI Wake County, saw generally poor outcomes from law enforcement interaction with those suffering mental disturbances. People got hurt or ended up in jail and prison without treatment for the conditions that caused their behavior — meaning the cycle of police involvement and incarceration was likely to continue.

In 2008, CIT training courses began in Alamance County.

The 40-hour certification course teaches officers how to recognize the symptoms of mental illness and how to communicate with those in crisis. Topics and situations surrounding psychological disorders to substance abuse and suicide intervention are covered. The training also puts law enforcement in touch with a local network of agencies and treatment centers.

Often, de-escalation results in people voluntarily seeking treatment and requiring no further police action, Mayer said.

Since 2008, 76 officers with 10 law enforcement agencies in Alamance and Caswell counties have earned CIT certification. Every law enforcement agency in the county has at least one CIT-certified officer.

The training program is coordinated locally by NAMI, law enforcement and Cardinal Innovations Healthcare Solutions — which oversees the county’s mental health services.

The course includes sessions by local psychiatrists, psychologists and service providers, discussions and interaction with individuals diagnosed with common disorders and their families, and education about medications and their side-effects.

Before CIT training became common here, officers had little education about mental illness, said Vanessa Jennings with NAMI Alamance-Caswell-Rockingham. Basic Law Enforcement Training courses generally included fewer than five hours of training on issues surrounding mental illness.

Earlier this year, NAMI and Rockingham County Sheriff Sam Page changed the BLET curriculum to include about 20 hours of instruction on mental health subjects, Jennings said.

Woznick believes more education is the only way to begin making a dent in the state’s mental health system. Since he was CIT certified several years ago, he’s encouraged most of Gibsonville’s officers to complete the training.

“(Mental illness) is oftentimes perceived as made up, that’s it’s not real and that people are just acting out,” Woznick said. “Someone with a mental illness is really no different from someone who’s having a heart attack or a stroke. CIT training makes you understand that.”

A number of Elon and Burlington police plan to attend CIT training sessions at Guilford Technical Community College in August and November. Additional CIT training is planned for Alamance Community College sometime later this year, Jennings said.